A critical threshold for global pediatric surgical workforce density.

Pediatric Surgery International
Megan E BouchardMonica Langer

Abstract

1.7 billion children lack access to surgical care, particularly in low- and middle-income countries (LMIC). The pediatric surgical workforce density (PSWD), an indicator of surgical access, correlates with survival of complex pediatric surgical problems. To determine if PSWD also correlates with population-level health outcomes for children, we compared PSWD with pediatric-specific mortality rates and determined the PSWD associated with improved survival. Using medical licensing registries, pediatric surgeons practicing in 26 countries between 2015 and 2019 were identified. Countries' PSWD was calculated as the ratio of pediatric surgeons per 100,000 children. The correlation between neonatal, infant and under 5 mortality rates and PSWD was assessed using Spearman's correlations and piecewise linear regression models. Four LIC, eight L-MIC, ten UMIC and four HIC countries, containing 420 million children, were analyzed. The median PSWD by income group was 0.03 (LIC), 0.12 (L-MIC), 1.34 (UMIC) and 2.13 (HIC). PSWD strongly correlated with neonatal (0.78, p < 0.001), infant (0.82, p < 0.001) and under 5 (0.83, p < 0.001) mortality rates. Survival improved with increasing PSWD to a threshold of 0.37. PSWD correlates with pediatric...Continue Reading

References

Jul 16, 2014·International Journal of Surgery·Rele OlogundeJoseph Shalhoub
Aug 20, 2014·World Journal of Surgery·Nicole A SitkinDiana L Farmer
Mar 19, 2015·Journal of Pediatric Surgery·Priti Lalchandani, James C Y Dunn
Aug 15, 2017·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Laura F GoodmanUNKNOWN GICS Collaborators
Dec 12, 2017·BMJ Global Health·Glenn Douglas GuestDavid A Watters
Apr 4, 2019·Bulletin of the World Health Organization·Bhargava MullapudiStephen Bickler
Mar 27, 2020·BMJ Open·Thiago Augusto Hernandes RochaUNKNOWN Global Initiative for Children’s Surgery
Jul 2, 2020·Global Health, Science and Practice·Isaac WassermanLubna Samad

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